Eating disorders in men and boys: they often go unnoticed

And when he began to speak publicly about his experience, an audience member – also a doctor – stood up to say that Sheldon had been misdiagnosed because he was neither extremely tall nor thin, a- he said.

Sheldon, 34, president of the National Eating Disorders Association’s Ambassador Program, has struggled with body image issues since he was 8 years old. When these problems turned into a concrete eating disorder, he had a hard time identifying it and getting help in part because of the stereotype that eating disorders only occur in teenage girls.

As the organization kicks off its awareness campaign Monday for National Eating Disorders Week, experts explain how eating disorders affect men and boys and why they are often left behind.

What does an eating disorder look like

When thinking of someone with an eating disorder, many people think of a girl or woman who restricts her food, obsessively exercises, or secretly binges and purges.

Men can experience eating disorders this way, said Dr. Blake Woodside, medical director emeritus of the eating disorders program at Toronto General Hospital and a professor in the department of psychiatry at the University of Toronto.

But men also feel pressure to conform to a few male body types that society deems acceptable, like the muscular superhero and the lanky computer geek, Woodside said.

Some of these ideals encourage men to limit their calorie count, but others do the opposite and encourage excessive training, overloading protein and severely restricting nutrients like fats and carbohydrates, Murray said.

When does the interest in maintaining a certain physique become an eating disorder? It happens when your behavior and interactions begin to be governed by the restrictions you put in place for your ideal body, Murray said.

“What should be the benchmark: does it impact people’s ability to lead normal, functional lives?” he said.

Why they are difficult to treat

If men are so affected by eating disorders, why aren’t we hearing about them? Stigma and exclusion.

Although anorexia nervosa was first identified in boys and girls in the 19th century, Murray said boys were excluded from research and diagnostic criteria.

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Until recently, changes in the breasts and loss of menstruation were key to diagnosing eating disorders, Murray said. Although the criteria have changed since then, men and boys are still excluded from most research on eating disorders, he added.

This exclusion can often lead to stigma, with men and boys – and those around them – not acknowledging their behavior or being hesitant to seek help because they believe it threatens their masculinity to say they may have a female-related disease.

To make matters worse, disordered eating behaviors in men are often championed in the world of social media, Murray said.

Celebrities and influencers are posting their excessive workouts, along with photos of their bodies and cheat meals of the day, which aim to keep their bodies from going into starvation mode so they don’t burn muscle, he said. added.

Without looking at the gender context, almost all doctors would classify this type of behavior as bulimia. In men, “we see it as kind of a prosocial way to get more muscular,” Murray said.

what we can do

Many families and family doctors are still unfamiliar with the signs of eating disorders in boys and men, Murray said, so the first thing to do is know what to look for.

Teenagers are human crickets, often demolishing every bite of food in their path, Woodside said. If you notice someone you care about abruptly changes how much or how much they eat publicly, they deserve attention, he said.

If the men or boys in your life are making big changes to activities and relationships in their lives, it might be time to take a closer look, Woodside added.

From there, there is good news and bad news.

The bad news? “The field of eating disorders needs to treat boys and men based on treatment studies that only included women. We need to make this big inference that we’re on the right track,” Murray said. .

But the good news is that men and boys often do well when undergoing treatment for their eating disorders, Woodside said.

At one point, Sheldon had lost his job, his money, and his relationships because of his eating disorder. It took years of specialized treatment and help from support groups to get her body and life back on track.

Now, he says, the best way to help men and boys like him get into treatment is to share the often-hidden truth: They’re not alone.


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